Heading It Off

userpic=headacheI’ve written before, numerous times, about how I’m a migraine sufferer. I’m lucky that my migraines are not severe; they are just dull and annoying. I rarely get any aura; my tell is my eye watering and a single-sided headache. Thankfully, I don’t usually need to hide in a dark room, away from stimuli, curled in a ball as many sufferers do. I can usually continue to work, perhaps at a degraded level, through them. They are, however, frequent and annoying.

My current regime uses a beta blocker (propranolol) and a muscle relaxant (tizanidine) as preventatives, and rizatriptan as my abortive. When I saw my neurologist a few weeks ago, she suggested adding another abortive to the mix: an old-line tricyclic antidepressant. They evidently have an off-label use to help block pain receptors. She recommended either nortriptyline or amitriptyline. I indicated I would research them, because I always have a concern of the effect of any medication on my ability to drive the vanpool, and on my mental acuity (which I need for my job). That’s a primary reason why I’ve never considered either topiramate (Topamax) or divalproex sodium (Depakote) as preventatives — both have significant impacts on mental alertness. Propranolol does just fine, and has the additional side effect of helping keep my blood pressure lower.

This week, I’m in a headache cycle (nearly daily, vs. weekly), and so this morning I reviewed the side effects of both nortriptyline and amitriptyline. Both can make one drowsy, and each has potential side effects that aren’t appealing. I’ve also looked at the reviews for each as a migraine preventative (N, A). Both have a lot of positive reviews. Still, I’m hesitant about anything that monkeys with brain chemistry. So, on the off chance anyone reading this has used them, I’d like to know your experiences. This will serve as input to deciding whether to just keep with what I’m doing, or to add one of these.